Nadir Aldosterone Levels After Confirmatory Tests Are Correlated With Left Ventricular Hypertrophy in Primary Aldosteronism
Left ventricular hypertrophy (LVH) is often seen in patients with primary aldosteronism (PA), and the prevalence of LVH is reportedly higher among patients with PA than patients with essential hypertension. However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone...
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| creator | Ohno, Youichi Sone, Masakatsu Inagaki, Nobuya Kawashima, Akiyuki Takeda, Yoshiyu Yoneda, Takashi Kurihara, Isao Itoh, Hiroshi Tsuiki, Mika Ichijo, Takamasa Katabami, Takuyuki Wada, Norio Sakamoto, Ryuichi Ogawa, Yoshihiro Yoshimoto, Takanobu Yamada, Tetsuya Kawashima, Junji Matsuda, Yuichi Kobayashi, Hiroki Kamemura, Kohei Yamamoto, Koichi Otsuki, Michio Okamura, Shintaro Izawa, Shoichiro Okamoto, Ryuji Tamura, Kouichi Tanabe, Akiyo Naruse, Mitsuhide |
| description | Left ventricular hypertrophy (LVH) is often seen in patients with primary aldosteronism (PA), and the prevalence of LVH is reportedly higher among patients with PA than patients with essential hypertension. However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. In the 1186 patients with PA studied, the basal plasma aldosterone concentration, plasma renin activity, and the aldosterone-to-renin ratio did not significantly correlate with left ventricular LV mass index (LVMI) in single or multiple regression analyses. However, the plasma aldosterone concentration after the captopril challenge test or saline-infusion test, which are associated with autonomous aldosterone secretion, correlated significantly with LVMI, even after adjusting for patients’ backgrounds, including age and blood pressure. In addition, hypokalemia and the unilateral subtype also correlated with LVMI. Longitudinal subanalysis of medically or surgically treated patients with PA showed significant reductions in LVMI in both the surgery (63.0±18.1 to 55.3±19.5 g/m2.7, P |
| doi_str_mv | 10.1161/HYPERTENSIONAHA.119.14601 |
| format | Article |
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However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. In the 1186 patients with PA studied, the basal plasma aldosterone concentration, plasma renin activity, and the aldosterone-to-renin ratio did not significantly correlate with left ventricular LV mass index (LVMI) in single or multiple regression analyses. However, the plasma aldosterone concentration after the captopril challenge test or saline-infusion test, which are associated with autonomous aldosterone secretion, correlated significantly with LVMI, even after adjusting for patients’ backgrounds, including age and blood pressure. In addition, hypokalemia and the unilateral subtype also correlated with LVMI. Longitudinal subanalysis of medically or surgically treated patients with PA showed significant reductions in LVMI in both the surgery (63.0±18.1 to 55.3±19.5 g/m2.7, P<0.001) and drug treatment (56.8±14.1 to 52.1±13.5 g/m2.7, P<0.001) groups. Our results suggest the autonomous aldosterone secretion level, not the basal aldosterone level itself, is relevant to LVH in patients with PA. 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However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. In the 1186 patients with PA studied, the basal plasma aldosterone concentration, plasma renin activity, and the aldosterone-to-renin ratio did not significantly correlate with left ventricular LV mass index (LVMI) in single or multiple regression analyses. However, the plasma aldosterone concentration after the captopril challenge test or saline-infusion test, which are associated with autonomous aldosterone secretion, correlated significantly with LVMI, even after adjusting for patients’ backgrounds, including age and blood pressure. In addition, hypokalemia and the unilateral subtype also correlated with LVMI. Longitudinal subanalysis of medically or surgically treated patients with PA showed significant reductions in LVMI in both the surgery (63.0±18.1 to 55.3±19.5 g/m2.7, P<0.001) and drug treatment (56.8±14.1 to 52.1±13.5 g/m2.7, P<0.001) groups. Our results suggest the autonomous aldosterone secretion level, not the basal aldosterone level itself, is relevant to LVH in patients with PA. In addition, the elevated LVMI seen in patients with PA is at least partially reversible with surgical or medical treatment.</description><subject>Adrenalectomy - methods</subject><subject>Adrenalectomy - statistics & numerical data</subject><subject>Aldosterone - blood</subject><subject>Blood Pressure - physiology</subject><subject>Cardiovascular System & Cardiology</subject><subject>Correlation of Data</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperaldosteronism - blood</subject><subject>Hyperaldosteronism - epidemiology</subject><subject>Hyperaldosteronism - physiopathology</subject><subject>Hyperaldosteronism - therapy</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - etiology</subject><subject>Hypertrophy, Left Ventricular - blood</subject><subject>Hypertrophy, Left Ventricular - diagnosis</subject><subject>Hypertrophy, Left Ventricular - epidemiology</subject><subject>Hypertrophy, Left Ventricular - etiology</subject><subject>Hypokalemia - diagnosis</subject><subject>Hypokalemia - epidemiology</subject><subject>Japan - epidemiology</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mineralocorticoid Receptor Antagonists - therapeutic use</subject><subject>Peripheral Vascular Disease</subject><subject>Registries - statistics & numerical data</subject><subject>Renin - blood</subject><subject>Science & Technology</subject><issn>0194-911X</issn><issn>1524-4563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkE9vEzEQxS0EomnhKyBzRltsr9drHzisVimpFKUVhH-nlXc9VgybdWQ7VFG_PC4pReKAerJn5v3m2Q-h15ScUyro28W36_mH9Xz18fJq1Sya3FTnlAtCn6AZrRgveCXKp2hGqOKFovTrCTqN8TshlHNeP0cnJWNc1qSaoduVNi7gZjQ-Jgh-AryEnzBG3Nhc49ZP1oWtTj4c8BpiyoMAuR0CjDqBwV9c2mTGJvwZphTcsB91wIvDDkIKfrc5YDfh6-C2Om_46-Pi9gV6ZvUY4eX9eYY-XczX7aJYXr2_bJtlMXBR04KyXnKmQNdUEiZVpYyse8FAUCJLK6xhxrCKGAVECD70AzESLO8JpXlal2dIHfcOwccYwHa743M6Srq7QLt_As1N1f0ONLOvjuxu32_BPJB_EswCeRTcQO9tHBxMAzzICMkSwXjJ8o2x1iWdnJ9av59SRt88Hs3qd_dqP-YE449xfwOh24Ae0-ZRP-H_4bMH4UzIgpHsJ3JV3NmS8hf6MLmP</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Ohno, Youichi</creator><creator>Sone, Masakatsu</creator><creator>Inagaki, Nobuya</creator><creator>Kawashima, Akiyuki</creator><creator>Takeda, Yoshiyu</creator><creator>Yoneda, Takashi</creator><creator>Kurihara, Isao</creator><creator>Itoh, Hiroshi</creator><creator>Tsuiki, Mika</creator><creator>Ichijo, Takamasa</creator><creator>Katabami, Takuyuki</creator><creator>Wada, Norio</creator><creator>Sakamoto, Ryuichi</creator><creator>Ogawa, Yoshihiro</creator><creator>Yoshimoto, Takanobu</creator><creator>Yamada, Tetsuya</creator><creator>Kawashima, Junji</creator><creator>Matsuda, Yuichi</creator><creator>Kobayashi, Hiroki</creator><creator>Kamemura, Kohei</creator><creator>Yamamoto, Koichi</creator><creator>Otsuki, Michio</creator><creator>Okamura, Shintaro</creator><creator>Izawa, Shoichiro</creator><creator>Okamoto, Ryuji</creator><creator>Tamura, Kouichi</creator><creator>Tanabe, Akiyo</creator><creator>Naruse, Mitsuhide</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0003-0107-9315</orcidid><orcidid>https://orcid.org/0000-0001-8261-2593</orcidid><orcidid>https://orcid.org/0000-0002-0834-2836</orcidid></search><sort><creationdate>20200601</creationdate><title>Nadir Aldosterone Levels After Confirmatory Tests Are Correlated With Left Ventricular Hypertrophy in Primary Aldosteronism</title><author>Ohno, Youichi ; Sone, Masakatsu ; Inagaki, Nobuya ; Kawashima, Akiyuki ; Takeda, Yoshiyu ; Yoneda, Takashi ; Kurihara, Isao ; Itoh, Hiroshi ; Tsuiki, Mika ; Ichijo, Takamasa ; Katabami, Takuyuki ; Wada, Norio ; Sakamoto, Ryuichi ; Ogawa, Yoshihiro ; Yoshimoto, Takanobu ; Yamada, Tetsuya ; Kawashima, Junji ; Matsuda, Yuichi ; Kobayashi, Hiroki ; Kamemura, Kohei ; Yamamoto, Koichi ; Otsuki, Michio ; Okamura, Shintaro ; Izawa, Shoichiro ; Okamoto, Ryuji ; Tamura, Kouichi ; Tanabe, Akiyo ; Naruse, Mitsuhide</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4671-12b8429ea718028959d87b62e61083f6fd2dd250d9e0664cbc0d8ef4b011f6f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adrenalectomy - 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However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. In the 1186 patients with PA studied, the basal plasma aldosterone concentration, plasma renin activity, and the aldosterone-to-renin ratio did not significantly correlate with left ventricular LV mass index (LVMI) in single or multiple regression analyses. However, the plasma aldosterone concentration after the captopril challenge test or saline-infusion test, which are associated with autonomous aldosterone secretion, correlated significantly with LVMI, even after adjusting for patients’ backgrounds, including age and blood pressure. In addition, hypokalemia and the unilateral subtype also correlated with LVMI. Longitudinal subanalysis of medically or surgically treated patients with PA showed significant reductions in LVMI in both the surgery (63.0±18.1 to 55.3±19.5 g/m2.7, P<0.001) and drug treatment (56.8±14.1 to 52.1±13.5 g/m2.7, P<0.001) groups. Our results suggest the autonomous aldosterone secretion level, not the basal aldosterone level itself, is relevant to LVH in patients with PA. In addition, the elevated LVMI seen in patients with PA is at least partially reversible with surgical or medical treatment.</abstract><cop>PHILADELPHIA</cop><pub>American Heart Association, Inc</pub><pmid>32248705</pmid><doi>10.1161/HYPERTENSIONAHA.119.14601</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0107-9315</orcidid><orcidid>https://orcid.org/0000-0001-8261-2593</orcidid><orcidid>https://orcid.org/0000-0002-0834-2836</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Hypertension (Dallas, Tex. 1979), 2020-06, Vol.75 (6), p.1475-1482 |
| issn | 0194-911X 1524-4563 |
| language | eng |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Adrenalectomy - methods Adrenalectomy - statistics & numerical data Aldosterone - blood Blood Pressure - physiology Cardiovascular System & Cardiology Correlation of Data Female Humans Hyperaldosteronism - blood Hyperaldosteronism - epidemiology Hyperaldosteronism - physiopathology Hyperaldosteronism - therapy Hypertension - diagnosis Hypertension - epidemiology Hypertension - etiology Hypertrophy, Left Ventricular - blood Hypertrophy, Left Ventricular - diagnosis Hypertrophy, Left Ventricular - epidemiology Hypertrophy, Left Ventricular - etiology Hypokalemia - diagnosis Hypokalemia - epidemiology Japan - epidemiology Life Sciences & Biomedicine Male Middle Aged Mineralocorticoid Receptor Antagonists - therapeutic use Peripheral Vascular Disease Registries - statistics & numerical data Renin - blood Science & Technology |
| title | Nadir Aldosterone Levels After Confirmatory Tests Are Correlated With Left Ventricular Hypertrophy in Primary Aldosteronism |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-13T02%3A17%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_webof&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Nadir%20Aldosterone%20Levels%20After%20Confirmatory%20Tests%20Are%20Correlated%20With%20Left%20Ventricular%20Hypertrophy%20in%20Primary%20Aldosteronism&rft.jtitle=Hypertension%20(Dallas,%20Tex.%201979)&rft.au=Ohno,%20Youichi&rft.aucorp=JPAS%20JRAS%20Study%20Grp&rft.date=2020-06-01&rft.volume=75&rft.issue=6&rft.spage=1475&rft.epage=1482&rft.pages=1475-1482&rft.issn=0194-911X&rft.eissn=1524-4563&rft_id=info:doi/10.1161/HYPERTENSIONAHA.119.14601&rft_dat=%3Cpubmed_webof%3E32248705%3C/pubmed_webof%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/32248705&rfr_iscdi=true |